DESCRIPTION (adapted from the Abstract): The study of HIV-1 in the genital tract of women is necessary to understand pathogenesis, vaccine design, and heterosexual and mother-to-child transmission. In addition, in this era of potent antiviral therapy, examination of HIV-1 reservoirs in the genital tract is a high priority. Some have hypothesized that viruses from the genital tract and plasma differ from each other and that these differences affect HIV-1 disease progression. To test this hypothesis, the Candidate proposes to determine complete HIV-1 RNA sequences from virus in the genital tract, specifically the cervicovaginal lavage (CVL), and compare them to contemporaneous plasma sequences from the same individual. The Candidate and associates have developed a technique based on reverse transcription and long PCR to clone full-length HIV-1 RNA genomes from infected individuals. He now proposes to use this technique to analyze samples from participants in the NIH Women's Interagency HIV Study (WIHS), a longitudinal cohort study of HIV-1 infection in women, selecting participants who represent clinically significan endpoints.